FAQ’s on Back Pain Treatment in Las Vegas

Back pain can be short-term (acute) or long-term (chronic). It is not the same for every patient, either. Some people have only mild, nagging back pain that does not interfere with daily activities, whereas others have severe pain that is disabling. Approximately 80 percent of back pain goes away with minimal treatment. However, for some patients, back pain is a life-long problem.

How common is chronic back pain?

Experts estimate that approximately 10 percent of U.S. citizens report back pain that occurs at some point during the year. Back pain is more common among middle-aged people, and women are more often affected. The direct medical costs of back pain is reported at around $24 billion per year.

What structures of the back are associated with chronic back pain?

The back is composed of 24 irregular-shaped bones called vertebrae. Each bone is separated by a cushioning disc, which is filled with a gel-like material. Muscles and soft tissue structures hold the spine together. The vertebrae join together and form small facet joints along the posterior region of the spine. The spinal cord runs through a canal that is formed by the back portion of the vertebrae. Spinal nerves spur off the spinal cord. Damage, degeneration, or injury to any of these structures can lead to chronic back pain.

What symptoms are associated with chronic back pain?

Chronic back pain can be mild and aching, moderate and throbbing, or severe and stabbing. It can come and go (intermittent), or it can be constant. Symptoms associated with back pain include weakness, numbness, and tingling of one or both legs, pain that radiates down the buttock into the leg, and foot discomfort.

What are some common causes of back pain?

Conditions that can lead to chronic back pain include:

  • Bulging disc
  • Herniated disc
  • Degenerative disc disease
  • Spinal arthritis
  • Facet joint syndrome
  • Spinal stenosis
  • Ankylosing spondylitis

How is chronic back pain diagnosed?

The doctor will conduct a physical examination and take a medical history to diagnose back pain. To discover the underlying cause of the pain, the doctor uses diagnostic testing. These tests include radiographs (x-rays), magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, and myleograms.

How is chronic back pain treated?

The treatment of chronic back pain depends on the underlying condition and severity of the injury or damage to the back structures. Treatment options include:

  • Medications – A combination of medications is often prescribed by the pain management specialist. These include muscle relaxants (Baclofen and Robaxin), anti-inflammatory agents (Prednisone, Ketoprofen, and Naproxen), antidepressants (Amitriptyline and Nortriptyline), and anticonvulsants (Lyrica and Neurontin).

 

  • Physical therapy – The doctor will usually recommend a course of physical therapy for the patient with chronic back pain. This exercise program improves posture, increases spine flexibility, and strengthens muscles.

 

  • Medial branch block (MBB) – The doctor will inject a long-acting anesthetic onto the nerves near the spinal cord. The needle is inserted into the facet joint to reach these nerves using x-ray guidance (fluoroscopy). A recent research study found that this procedure had an 85% success rate, and most participants reported functional improvement as well as pain relief.

 

  • Radiofrequency ablation (RFA) – If a block works for nerve-related back pain, the pain specialist may perform RFA. With this procedure, a special needle and probe is inserted near the affected nerves, and radiofrequency energy is applied to destroy a portion of the nerve root.

 

  • Epidural steroid injection (ESI) – Usually done in a series of three, the doctor injects a corticosteroid agent into the epidural space, which is near the spinal nerves. According to clinical studies, ESIs are 90% effective for relief of chronic back pain.

Resources

McLain RF, Kapural L, & Mekhail NA (2005). Epidural steroid therapy for back and legpain: mechanism of action and efficacy. Spine Journal, 5, 191-201

Riew KD, Park JB, Cho YS, et al. (2006). Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg Am, 88(8), 1722-1725.